While opioid prescribing for acute pain in U.S. emergency departments (EDs) is more
consistent with recommendations for a 3-day or less supply than in other settings,
the average number of tablets prescribed still remains highly variable [
1
,
2
,
3
]. Furthermore, larger initial prescriptions are associated with prolonged opioid
use and potential for misuse [
[2]
,
[3]
]. Setting default tablet order amounts lower than the baseline average (e.g. 10 tablets)
reduces the tablet number prescribed [
[4]
]. Conversely, if set too high (e.g. 20 tablets), prescribers are nudged into prescribing
more than they would have without a default [
[5]
]. It is unknown whether EDs have default orders for opioid amounts and whether these
defaults are consistent with the recommended 3-day supply (typically ≤12 tablets)
[
[6]
]. Thus, we conducted a national survey of U.S. EDs to determine the presence and
size of default opioid tablet amounts.Keywords
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References
- Opioid prescribing in a cross section of US emergency departments.Ann Emerg Med. 2015; 66: 253-259.E1https://doi.org/10.1016/j.annemergmed.2015.03.026
- National variation in opioid prescribing and risk of prolonged use for opioid-naive patients treated in the emergency Department for Ankle Sprains.Ann Emerg Med. 2018; 72: 389-400https://doi.org/10.1016/j.annemergmed.2018.06.003
- Opioid-prescribing patterns of emergency physicians and risk of long-term use.N Engl J Med. 2017; 376: 663-673https://doi.org/10.1056/NEJMsa1610524
- Association between electronic medical record implementation of default opioid prescription quantities and prescribing behavior in two emergency departments.J Gen Intern Med. 2018; : 1-3
- By default: the effect of prepopulated prescription quantities on opioid prescribing in the emergency department.West J Emerg Med. 2018; 19: 392-397https://doi.org/10.5811/westjem.2017.10.33798
- Emergency department opioid prescribing guidelines for the treatment of non-cancer related pain.
Article Info
Publication History
Published online: March 12, 2019
Accepted:
March 12,
2019
Received:
March 3,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
